Search results for: high surface quality

Authors: Naridchaya Aberdour, Joanna Kao, Anne Miller, Timothy Shore, Richard Maher, Zhixin Liu

Abstract:

Background: COVID-19 has and continues to be a strain on healthcare globally, with the number of patients requiring hospitalization exceeding the level of medical support available in many countries. As chest x-rays are the primary respiratory radiological investigation, the Radiological Assessment of Lung Edema (RALE) score was used to quantify the extent of pulmonary infection on baseline imaging. Assessment of RALE score's reproducibility and associations with clinical outcome parameters were then evaluated to determine implications for patient management and prognosis. Methods: A retrospective study was performed with the inclusion of patients testing positive for COVID-19 on nasopharyngeal swab within a single Local Health District in Sydney, Australia and baseline x-ray imaging acquired between January to June 2020. Two independent Radiologists viewed the studies and calculated the RALE scores. Clinical outcome parameters were collected and statistical analysis was performed to assess RALE score reproducibility and possible associations with clinical outcomes. Results: A total of 78 patients met inclusion criteria with the age range of 4 to 91 years old. RALE score concordance between the two independent Radiologists was excellent (interclass correlation coefficient = 0.93, 95% CI = 0.88-0.95, p<0.005). Binomial logistics regression identified a positive correlation with hospital admission (1.87 OR, 95% CI= 1.3-2.6, p<0.005), oxygen requirement (1.48 OR, 95% CI= 1.2-1.8, p<0.005) and invasive ventilation (1.2 OR, 95% CI= 1.0-1.3, p<0.005) for each 1-point increase in RALE score. For each one year increased in age, there was a negative correlation with recovery (0.05 OR, 95% CI= 0.92-1.0, p<0.01). RALE scores above three were positively associated with hospitalization (Youden Index 0.61, sensitivity 0.73, specificity 0.89) and above six were positively associated with ICU admission (Youden Index 0.67, sensitivity 0.91, specificity 0.78). Conclusion: The RALE score can be used as a surrogate to quantify the extent of COVID-19 infection and has an excellent inter-observer agreement. The RALE score could be used to prognosticate and identify patients at high risk of deterioration. Threshold values may also be applied to predict the likelihood of hospital and ICU admission.

Keywords: chest radiography, coronavirus, COVID-19, RALE score

Procedia PDF Downloads 178

Authors: Ibrahim Aliyu Isah, Mohd Mansor Ismail, Salim Hassan, Norsida Man, Oluwatoyin Olagunju

Abstract:

Stingless beekeeping is not only a profitable activity for Malaysian beekeepers but also for the Malaysian economy. However, natural honey has faced some difficulties, which resulted in low production due to a lack of information on improved technology as well as the capacity and potential building of stingless beekeeping farmers, which depend mostly on information received from the extension agents. Hence, it is the responsibility of the extension agents to give useful information on the available technology and develop the capacity of the farmers to make the right decision that will improve their level of production. This study assessed how technology transfer and human resource development skills influence the work performance of the extension agents toward sustainable beekeeping production among beekeepers. The study sought to establish the role of relevant technology transfer and human resource development skills in effective performance. The research design was a descriptive and quantitative survey of stingless beekeepers on technology transfer and human resource development by the extension agent. Data was obtained from 54 beekeeping farmers and was analyzed using descriptive and inferential statistics. The results revealed that technology skill, technology dissemination skill, technology evaluation skill, Decision-making process skill, Leadership development skill and work performance were rated moderate by stingless beekeeping farmers, while Social skill was rated high. A significant and positive correlation (P<0.01) existed between all variables and performance. Regression results showed that leadership development skills, Decision-making process skills, and social skills are significant (P=.05), while technology skills, technology dissemination skills, and technology evaluation skills are not significant. The highest contributing factor is social skill (β=.446). Beekeeping is a profitable project in Malaysia and can be sustained if the extension services and programs are well carried out by competent extension agents and relevant agricultural government agencies.

Keywords: beekeeping, extension agents, human resource development, sustainable, technology transfer, work performance

Procedia PDF Downloads 63

Authors: Rachel Goh, Alexander McNab, Brent Alsop, David O'Hare

Abstract:

In a busy airport, the decision whether to take passengers aside and search their luggage for dangerous items can have important consequences. If an officer fails to search and stop a bag containing a dangerous object, a life-threatening incident might occur. But stopping a bag unnecessarily means that the officer might lose time searching the bag and face an angry passenger. Passengers’ bags, however, are often cluttered with personal belongings of varying shapes and sizes. It can be difficult to determine what is dangerous or not, especially if the decisions must be made quickly in cases of busy flight schedules. Additionally, the decision to search bags is often made with input from the surrounding officers on duty. This scenario raises several questions: 1) Past findings suggest that humans are more reliant on an automated aid when under time pressure in a visual search task, but does this translate to human-human reliance? 2) Are humans more likely to agree with another person if the person is assumed to be an expert or a novice in these ambiguous situations? In the present study, forty-one participants performed a simulated luggage-screening task. They were partnered with an advisor of two different statuses (expert vs. novice), but of equal accuracy (90% correct). Participants made two choices each trial: their first choice with no advisor input, and their second choice after advisor input. The second choice was made within either 2 seconds or 8 seconds; failure to do so resulted in a long time-out period. Under the 2-second time pressure, participants were more likely to disagree with their own first choice and agree with the expert advisor, regardless of whether the expert was right or wrong, but especially when the expert suggested that the bag was safe. The findings indicate a tendency for people to assume less responsibility for their decisions and defer to their partner, especially when a quick decision is required. This over-reliance on others’ opinions might have negative consequences in real life, particularly when relying on fallible human judgments. More awareness is needed regarding how a stressful environment may influence reliance on other’s opinions, and how better techniques are needed to make the best decisions under high stress and time pressure.

Keywords: advisors, decision-making, time pressure, trust

Procedia PDF Downloads 173

Authors: Randall E. Osborne

Abstract:

A four-step ‘humanities’ thought model has been used in an interdisciplinary course for almost two decades and has been proven to aid in student abilities to become more inclusive in their world view. Lack of tolerance for ambiguity can interfere with this progression so we developed an assignment that seems to have assisted students in developing more tolerance for ambiguity and, therefore, opened them up to make more progress on the critical thought model. A four-step critical thought model (built from a humanities education approach) is used in an interdisciplinary course on prejudice, discrimination, and hate in an effort to minimize egocentrism and promote sociocentrism in college students. A fundamental barrier to this progression is a lack of tolerance for ambiguity. The approach to the course is built on the assumption that Tolerance for Ambiguity (characterized by a dislike of uncertain, ambiguous or situations in which expected behaviors are uncertain, will like serve as a barrier (if tolerance is low) or facilitator (if tolerance is high) of active ‘engagement’ with assignments. Given that active engagement with course assignments would be necessary to promote an increase in critical thought and the degree of multicultural attitude change, tolerance for ambiguity inhibits critical thinking and, ultimately multicultural attitude change. As expected, those students showing the least amount of decrease (or even an increase) in intolerance across the semester, earned lower grades in the course than those students who showed a significant decrease in intolerance, t(1,19) = 4.659, p < .001. Students who demonstrated the most change in their Tolerance for Ambiguity (showed an increasing ability to tolerate ambiguity) earned the highest grades in the course. This is, especially, significant because faculty did not know student scores on this measure until after all assignments had been graded and course grades assigned. An assignment designed to assist students in making their assumption and inferences processes visible so they could be explored, was implemented with the goal of this exploration then promoting more tolerance for ambiguity, which, as already outlined, promotes critical thought. The assignment offers students two options and then requires them to explore what they have learned about inferences and/or assumptions This presentation outlines the assignment and demonstrates the humanities model, what students learn from particular assignments and how it fosters a change in Tolerance for Ambiguity which, serves as the foundational component of critical thinking.

Keywords: critical thinking, humanities education, sociocentrism, tolerance for ambiguity

Procedia PDF Downloads 273

Authors: G. Gevorgyan, S. Khudaverdyan, A. Vaseashta

Abstract:

The Lake Sevan basin is situated in the eastern part of the Republic of Armenia (Gegharquniq marz/district). The heavy metal pollution of the some tributaries of Lake Sevan was investigated. Water sampling was performed in August and December, 2014 from the 4 observation sites: 1) Sotq river upstream (about 600 meters upstream from the Sotq gold mine); 2) Sotq river mouth; 3) Masrik river mouth; 4) Dzknaget river mouth. Heavy metal (V, Fe, Ni, Cu, As, Mo, Pb) concentrations in the water samples were determined by the standard methods using an atomic absorption spectrophotometer. The results of the study showed that heavy metal content mainly increased from the upstream of the Sotq river to the mouth of the Masrik river which may have been conditioned by the influence of gold mining activity as the Masrik and its tributary-Sotq rivers passing through the gold mining area were exposed to heavy metal pollution. The observation sites can be ranked by pollution degree as follows: №3> №2> №1> №4. The highest heavy metal pollution degree was observed in the Masrik river mouth which may have been conditioned by the direct impact of gold mining activity and the pressure of its tributary–the Sotq river which flows through the gold mining area. The lowest heavy metal pollution degree was registered in the Dzknaget river mouth which flowing through rural areas wasn’t subject to significant heavy metal pollution. According to the observation sites of the Sotq and Masrik rivers, high positive correlation was mainly observed between the concentrations of the investigated heavy metals (except nickel) which indicated that all the heavy metals except the nickel had the same anthropogenic pollution source which was the activity of the Sotq gold mine. In general, it is possible to state that the activity of the Sotq gold mine in the Lake Sevan basin caused the heavy metal pollution of the Sotq and Masrik rivers which may have posed environmental hazards. Heavy metals are nondegradable substances, and heavy metal pollution of freshwater systems may pose risks to the environment and human health through accumulation in the tissues of aquatic organisms, water-food chain as well as oral ingestion and dermal contact.

Keywords: Armenia, Lake Sevan basin, gold mining activity, river ecosystems, heavy metal pollution

Procedia PDF Downloads 584

Authors: Md Mizanur Rahman, Lotanna Micah Nneji, Adeola C. Adeniyi, Edem Archibong Eniang, Abiodun B. Onadeko, Felista Kasyoka Kilunda, Babatunde E. Adedeji, Ifeanyi C. Nneji, Adiaha A. A. Ugwumba, Jie-Qiong Jin, Min-Sheng Peng, Caroline Olory, Nsikan Eninekit, Jing Che

Abstract:

Nigeria contains a number of forest habitats that believed to host highly rich amphibian diversity. However, a dearth of herpetological studies has restricted information on the amphibian diversity in Nigeria. To cover the gap of knowledge, this study focused field surveys on relatively less studied forests–Afi Forest Reserve and Ikpan forest ecosystem. The goal of this study is to make a checklist and to investigate the habitat preferences of amphibians in these two forests. The study areas were surveyed between August 2018 and July 2019 following visual and acoustic methods. Individuals were identified using the morphological and molecular (16S ribosomal RNA) approach. Literature searches were conducted to document additional species that were not encountered during the current field surveys. Using the observational records and arrays of diversity indices, the patterns of species richness and abundance across habitat types were evaluated. Voucher specimens and tissue samples were deposited in the museums of the Department of Zoology, University of Ibadan Nigeria, and the remainder at the Kunming Institute of Zoology (KIZ), Chinese Academy of Sciences, Kunming, China. The result of this study revealed the presence of 30 and 31 amphibian species from the Afi Forest Reserve and the Ikpan Forest Ecosystem, respectively. There were two unidentified species from AFR and one from IFE. In total, 324 individuals of amphibian species were observed from the two study areas. Forest and swamps showed high species diversity and richness than the agricultural field and savannah. Savannah and agricultural fields had the highest similarity in the species composition. Given the increased human disturbances and consequent threats to these forests, this study offers recommendations for the initiation of conservation plans immediately.

Keywords: biodiversity, conservation, cryptic species, ecology, integrated taxonomy, species inventory

Procedia PDF Downloads 167

Authors: Susanna Asatryan

Abstract:

The author will introduce the Language Portfolio for master course student-teachers of Yerevan Brusov State University of Languages and Social Sciences The overall aim of the Portfolio is to serve as a visual didactic tool for the pedagogical internship of master students in specialization “A Foreign Language Teacher of High Schools and Professional Educational Institutions”, based on the principles and fundamentals of the EPOSTL. The author will present the parts of the Portfolio, including the programme, goal and objectives of student-teacher’s internship, content and organization, expected outputs and the principles of the student’s self-assessment, based on Can-do philosophy suggested by the EPOSTL. The Language Portfolio for master course student-teachers outlines the distinctive stages of their scientific-pedagogical internship. In Lesson Observation and Teaching section student teachers present thematic planning of the syllabus course, including individual lesson plan-description and analysis of the lesson. In Realization of the Scientific-Pedagogical Research section student-teachers introduce the plan of their research work, its goal, objectives, steps of procedure and outcomes. In Educational Activity section student-teachers analyze the educational sides of the lesson, they introduce the plan of the extracurricular activity, provide psycho-pedagogical description of the group or the whole class, and outline extracurricular entertainments. In the Dossier the student-teachers store up the entire instructional “product” during their pedagogical internship: e.g. samples of surveys, tests, recordings, videos, posters, postcards, pupils’ poems, photos, pictures, etc. The author’s presentation will also cover the Self Assessment Checklist, which highlights the main didactic competences of student-teachers, extracted from the EPOSTL. The Self Assessment Checklist is introduced with some innovations, taking into consideration the local educational objectives that Armenian students come across with. The students’ feedback on the use of the Portfolio will also be presented.

Keywords: internship, lesson observation, can-do philosophy, self-assessment

Procedia PDF Downloads 242

Authors: Christiane Dumont

Abstract:

This paper proposes to revisit foreign-language learning as a tool to increase motivation through advocacy and develop effective natural communication skills, which are critical leadership qualities. To this end, collaborative initiatives undertaken by advanced university students of French with local and international community partners will be reviewed. Close attention will be paid to the acquisition of intercultural skills, the reflective process, as well as the challenges and outcomes. Two international development projects conducted in Haiti will be highlighted, i.e., collaboration with a network of providers in the Haitian cultural heritage preservation and tourism sector (2014-15) and development of investigation and teacher training tools for a primary/secondary school in the Port-au-Prince area (current). The choice of community-service learning as a framework to teach French-as-a-second-language stemmed from the need to raise awareness against stereotypes and prejudice, which hinder the development of effective intercultural skills. This type of experiential education also proved very effective in identifying and preventing miscommunication caused by the lack of face-to-face interaction in our increasingly technology-mediated world. Learners experienced first-hand, the challenges and advantages of face-to-face communication, which, in turn, enhanced their motivation for developing effective intercultural skills. Vygotsky's and Kolb's theories, current research on service learning (Dwight, Eyler), action/project-based pedagogy (Beckett), and reflective learning (TSC Farrell), will provide useful background to analyze the benefits and challenges of community-service learning. The ultimate goal of this paper is to find out what makes experiential learning truly unique and transformative for both the learners and the community they wish to serve. It will demonstrate how enhanced motivation, community engagement, and clear, concise, and respectful communication impact and empower learners. The underlying hope is to help students in high-profile, and leading-edge industries become effective global leaders.

Keywords: experiential learning, intercultural communication, reflective learning, effective leadership, learner motivation

Procedia PDF Downloads 105

Authors: Julia V. F. Cortes, Maria E. V. Amarante, Carolina L. Cerdeira, Roberta B. V. Silva

Abstract:

Nonmelanoma skin cancer is more commonly diagnosed than all other malignancies combined. In that group, cutaneous squamous cell carcinoma stands out for having the highest probability of metastasis and recurrence after treatment, in addition to being the second most prevalent form of skin cancer. Its main risk factors include exposure to carcinogens, such as ultraviolet radiation related to sunlight exposure, smoking, alcohol consumption, and human papillomavirus (HPV) infection. Considering the increased risk of skin cancer in the Brazilian population, caused by the high incidence of solar radiation, and the importance of identifying risk phenotypes for the accomplishment of public health actions, an epidemiological study was conducted in a city with a tropical climate located in southeastern Brazil, aiming to identify the target population and assist in primary and secondary prevention. This study describes the profile of patients with cutaneous squamous cell cancer, correlating the variables, sex, age, and differentiation. The study used as primary data source the results of anatomopathological exams delivered from January 2015 to December 2019 for patients registered at one pathology service, which analyzes the results of biopsies, Thus, 66 patients with cutaneous squamous cell carcinoma were analyzed. The most affected age group was 60 years or older (78.79%), emphasizing that moderately differentiated (79.49%) and well-differentiated forms (66.67%) are prevalent in this age group, resulting in a difference of 12.82 percentage points between them. In addition, the predominant sex was male (58%), and it was found that half of the women and 65.79% of men had a moderately differentiated type, whereas the well-differentiated type was slightly more frequent in women. It is worth noting that the moderately differentiated subtype has a 59.20% prevalence among all cases. Thus, it was concluded that the most affected age group was 60 years or older and that men were more affected. As for the subtype, the moderately differentiated one, which is recognized for presenting the second-highest risk for metastasis, was prevalent in this study, affecting 6.6% more men and predominating in the elderly.

Keywords: cutaneous squamous cell carcinoma, epidemiology, skin cancer, spinal cell cancer

Procedia PDF Downloads 117

Authors: K. Frahtia, I. Mihoubi, S. Picot

Abstract:

Leishmaniasis is a group of parasitic disease with a varied clinical expression caused by flagellate protozoa of the Leishmania genus. These diseases are transmitted to humans and animals by the sting of a vector insect, the female sandfly. Among the groups of dipteral disease vectors, Phlebotominae occupy a prime position and play a significant role in human pathology, such as leishmaniasis that affects nearly 350 million people worldwide. The vector control operation launched by health services throughout the country proves to be effective since despite the prevalence of the disease remains high especially in rural areas, leishmaniasis appears to be declining in Algeria. In this context, this study mainly concerns molecular detection of Leishmania from the vector. Furthermore, a molecular diagnosis has also been made on skin samples taken from patients in the region of Constantine, located in the North-East of Algeria. Concerning the vector, 5858 sandflies were captured, including 4360 males and 1498 females. Male specimens were identified based on their morphological. The morphological identification highlighted the presence of the Phlebotomus genus with a prevalence of 93% against 7% represented by the Sergentomyia genus. About the identified species, P. perniciosus is the most abundant with 59.4% of the male identified population followed by P. longicuspis with 24.7% of the workforce. P. perfiliewi is poorly represented by 6.7% of specimens followed by P. papatasi with 2.2% and 1.5% S. dreyfussi. Concerning skin samples, 45/79 (56.96%) collected samples were found positive by real-time PCR. This rate appears to be in sharp decline compared to previous years (alert peak of 30,227 cases in 2005). Concerning the detection of Leishmania from sandflies by RT-PCR, the results show that 3/60 PCR performed genus are positive with melting temperatures corresponding to that of the reference strain (84.1 +/- 0.4 ° C for L. infantum). This proves that the vectors were parasitized. On the other side, identification by RT-PCR species did not give any results. This could be explained by the presence of an insufficient amount of leishmanian DNA in the vector, and therefore support the hypothesis of the regression of leishmaniasis in Constantine.

Keywords: Algeria, molecular diagnostic, phlebotomus, real time PCR

Procedia PDF Downloads 272

Authors: Mark P. Mayala, Henry Mayala, Khuzeima Khanbhai

Abstract:

Background: Heart failure has been a rising concern in Tanzania. New drugs have been introduced, including the group of drugs called Angiotensin receptor Neprilysin Inhibitor (ARNI), but due to their high cost, angiotensin-converting enzymes inhibitors (ACEIs) and Angiotensin receptor blockers (ARBs) have been mostly used in Tanzania. However, according to our knowledge, the efficacy comparison of the two groups is yet to be studied in Tanzania. The aim of this study was to compare the efficacy of ACEIs and ARBs among patients with heart failure. Methodology: This was a hospital-based prospective cohort study done at Jakaya Kikwete Cardiac Institution (JKCI), Tanzania, from June to December 2020. Consecutive enrollment was done until fulfilling the inclusion criteria. Clinical details were measured at baseline. We assessed the relationship between ARBs and ACEIs users with N-terminal pro-brain natriuretic peptide (NT pro-BNP) levels at admission and at 1-month follow-up using a chi-square test. A Kaplan-Meier curve was used to estimate the survival time of the two groups. Results: 155 HF patients were enrolled, with a mean age of 48 years, whereby 52.3% were male, and their mean left ventricular ejection fraction (LVEF) was 37.3%. 52 (33.5%) heart failure patients were on ACEIs, 57 (36.8%) on ARBs, and 46 (29.7%) were neither using ACEIs nor ARBs. At least half of the patients did not receive a guideline-directed medical therapy (GDMT), with only 82 (52.9%) receiving a GDMT. A drop in NT pro-BNP levels was observed during admission and at 1-month follow-up on both groups, from 6389.2 pg/ml to 4000.1 pg/ml for ARB users and 5877.7 pg/ml to 1328.2 pg/ml for the ACEIs users. There was no statistical difference between the two groups when estimated by the Kaplan-Meier curve, though more deaths were observed in those who were neither on ACEIs nor ARBs, with a calculated P value of 0.01. Conclusion: This study demonstrates that ACEIs have more efficacy and overall better clinical outcome than ARBs, but this should be taken under the patient-based case, considering the side effects of ACEIs and patients’ adherence.

Keywords: angiotensin converting enzymes inhibitors, angiotensin receptor blockers, guideline direct medical therapy, N-terminal pro-brain natriuretic peptide

Procedia PDF Downloads 85

Authors: Rehin Sulay, Anandhu Krishna, Jintumol Mathew, Vibin Ipe Thomas

Abstract:

N-Nitrosodimethyl amine, the simplest member of the N-Nitrosoamine family, is a carcinogenic and mutagenic agent that has gained considerable research interest owing to its toxic nature. Ozonation of industrially important hydrazines such as unsymmetrical dimethylhydrazine (UDMH) or monomethylhydrazine (MMH) has been associated with NDMA formation and accumulation in the environment. UDMH/MMH - ozonation also leads to several other transformation products such as acetaldehyde dimethyl hydrazone (ADMH), tetramethyl tetra azene (TMT), diazomethane, methyl diazene, etc, which can be either precursors or competitors for NDMA formation.In this work, we explored the formation mechanism of ADMH and TMT from UDMH-ozonation and their further oxidation to NDMA using the second-order Moller Plesset perturbation theory employing the 6-311G(d) basis set. We have also investigated how MMH selectively forms methyl diazene and diazomethane under normal conditions and NDMA in the presence of excess ozone. Our calculations indicate that the reactions proceed via an initial H abstraction from the hydrazine –NH2 group followed by the oxidation of the generated N-radical species. The formation of ADMH from the UDMH-ozone reaction involves an acetaldehyde intermediate, which then reacts with a second UDMH molecule to generate ADMH. The preferable attack of ozone molecule on N=C bond of ADMH generates DMAN intermediate, which subsequently undergoes oxidation to form NDMA. Unlike other transformation products, TMT formation occurs via the dimerization of DMAN. Though there exist a N=N bonds in the TMT, which are preferable attacking sites for ozone, experimental studies show the lower yields of NDMA formation, which corroborates with the high activation barrier required for the process(42kcal/mol).Overall, our calculated results agree well with the experimental observations and rate constants. Computational calculations bring insights into the electronic nature and kinetics of the elementary reactions of this pathway, enabled by computed energies of structures that are not possible to access experimentally.

Keywords: reaction mechanism, ozonation, substituted hydrazine, transition state

Procedia PDF Downloads 82

Authors: Ahsan Ali, Mayank Ostwal, Nikhil Agarwal

Abstract:

Abstract—According to a World Bank report, millions of people across the globe still do not have access to improved water services. With uninterrupted growth of cities and urban inhabitants, there is a mounting need to safeguard the sustainable expansion of cities. Efficient functioning of the urban components and high living standards of the residents are needed to be ensured. The water and sanitation network of an urban development is one of its most essential parts of its critical infrastructure. The growth in urban population is leading towards increased water demand, and thus, the local water resources are severely strained. 'Smart water' is referred to water and waste water infrastructure that is able to manage the limited resources and the energy used to transport it. It enables the sustainable consumption of water resources through co-ordinate water management system, by integrating Information Communication Technology (ICT) solutions, intended at maximizing the socioeconomic benefits without compromising the environmental values. This paper presents a case study from a medium sized city in North-western Pakistan. Currently, water is getting contaminated due to the proximity between water and sewer pipelines in the study area, leading to public health issues. Due to unsafe grey water infiltration, the scarce ground water is also getting polluted. This research takes into account the design of smart urban water network by integrating ICT (Information and Communication Technology) with urban water network. The proximity between the existing water supply network and sewage network is analyzed and a design of new water supply system is proposed. Real time mapping of the existing urban utility networks will be projected with the help of GIS applications. The issue of grey water infiltration is addressed by providing sustainable solutions with the help of locally available materials, keeping in mind the economic condition of the area. To deal with the current growth of urban population, it is vital to develop new water resources. Hence, distinctive and cost effective procedures to harness rain water would be suggested as a part of the research study experiment.

Keywords: GIS, smart water, sustainability, urban water management

Procedia PDF Downloads 217

Authors: Seung Chul Lee, Jooyeong Kim, Ki Ok Ahn, Juok Park

Abstract:

Background: Injuries caused by motorcycle crashes are one of the major public health burdens leading to high mortality, functional disability. The risk of death among motorcyclists is 30 times greater than that among car drivers, with head injuries the leading cause of death. The motorcycle helmet is crucial protective equipment for motorcyclists. Aims: This study aimed to measure the protective effect of motorcycle helmet use on intracranial injury and mortality and to compare the preventive effect in drivers and passengers. Methods: This is a cross-sessional study based on the Emergency Department (ED)–based Injury In-depth Surveillance (EDIIS) database from 23 EDs in Korea. All of the trauma patients injured in motorcycle crashes between January 1, 2013 and December 31, 2016 were eligible, excluding cases with unknown helmet use and outcomes. The primary and secondary outcomes were intracranial injury and in-hospital mortality. We calculated adjusted odds ratios (AORs) of helmet use for study outcomes after adjusting for potential confounders. Using interaction models, we compared the protective effect of helmet use on outcomes across driving status (driver and passenger). Results: Among 17,791 eligible patients, 10,668 (60.0%) patients were wearing helmets at the time of the crash, 2,128 (12.0%) patients had intracranial injuries and 331 (1.9%) patients had in-hospital death. 16,381 (92.1%) patients were drivers and 1410 (7.9%) patients were passengers. 62.6% of drivers and 29.1% of passengers were wearing helmets at the time of the crash. Compared to un-helmeted group, the helmeted group was less likely to have an intracranial injury(8.0% vs. 17.9%, AOR: 0.43 (0.39-0.48)) and in-hospital mortality (1.0% vs. 3.2%, AOR: 0.29 (0.22-0.37)).In the interaction model, AORs (95% CIs) of helmet use for intracranial injury were 0.42 (0.38-0.47) in drivers and 0.61(0.41-0.90) in passengers, respectively. There was a significant preventive effect of helmet use on in-hospital mortality in drivers (AOR: 0.26(0.21–0.34)). Discussion and conclusions: Wearing helmets in motorcycle crashes reduced intracranial injuries and in-hospital mortality. The preventive effect of motorcycle helmet use on intracranial injury was stronger in drivers than in passengers. There was a significant preventive effect of helmet use on in-hospital mortality in driver but not in passengers. Public health efforts to increase motorcycle helmet use are needed to reduce health burden from injuries caused by motorcycle crashes.

Keywords: intracranial injury, helmet, mortality, motorcycle crashes

Procedia PDF Downloads 184

Authors: Ebere Christian Ugochukwu, Okafor Josephine, Oyawoye Tomisin

Abstract:

The occurrence of multidrug resistance patterns that have been developed by bacteria has made it difficult to properly treat infections using standard clinical medications. Hence, the use of herbs as an alternative source of therapy is considered cheap and easily accessible to locals. This research explored the antimicrobial effects of aqueous and ethanolic extracts obtained from Chrysophyllum albidum (commonly called ‘Agbalumo’ in southwest Nigeria and ‘Udara’ in the eastern and southern parts of Nigeria) plant parts (leaves, roots and seeds) against bacteria isolated from urinary catheter tips. The following isolates were obtained; Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Proteus mirabilis, and Klebsiella aerogenes. The agar well diffusion method was used. The average percentages of antimicrobial resistance of the isolates to gentamycin were 45.5% for P. aeruginosa, 42.1% for E. coli, 46.9% for K. aerogenes, and ˃90% for other isolates. Qualitative phytochemical screening of the plant parts extracts was done using chemical test for the screening and identification of bioactive chemical constituents. The ethanolic extract mixtures (leaf, root and seed) had the greatest effect on all the isolates, with inhibition zones (IZs) ranging from 8-26 mm and MICs ranging from <16-32 mg/ml. The Potencies of the C. albidum extracts based on the IZ and MIC values were greater in the extract mixtures, followed by those in the roots. Phytochemical screening revealed that all the extracts contained phenol except for the seeds while tannins were present in all the extracts except the leaves. The activity of the ethanolic extracts of each part at high and low concentrations was greater than that of the aqueous extracts at the same concentrations (p<0.05). The acute toxicity results showed that the LD50 of the extracts was ˃5000 mg/body weight, indicating no toxicity. The antibacterial activities of the extract mixtures and roots on the isolates confirmed the use of C. albidum in folk medicine for the treatment of CAUTIs, hence indicating its antibacterial potential for use in novel antibiotic production.

Keywords: antimicrobials, susceptibility, minimum inhibitory concentration, extracts

Procedia PDF Downloads 29

Authors: Muhammad Ajmal

Abstract:

- Thermal processing and subsequent storage of ultra-heat treated (UHT) milk leads to alteration in protein profile, Maillard reaction and lipid oxidation. Concentration of carbohydrates in normal and flavored version of UHT milk is considerably different. Transition in protein profile, Maillard reaction and lipid oxidation in UHT flavored milk was determined for 90 days at ambient conditions and analyzed at 0, 45 and 90 days of storage. Protein profile, hydroxymethyl furfural, furosine, Nε-carboxymethyl-l-lysine, fatty acid profile, free fatty acids, peroxide value and sensory characteristics were determined. After 90 days of storage, fat, protein, total solids contents and pH were significantly less than the initial values determined at 0 day. As compared to protein profile normal UHT milk, more pronounced changes were recorded in different fractions of protein in UHT milk at 45 and 90 days of storage. Tyrosine content of flavored UHT milk at 0, 45 and 90 days of storage were 3.5, 6.9 and 15.2 µg tyrosine/ml. After 45 days of storage, the decline in αs1-casein, αs2-casein, β-casein, κ-casein, β-lactoglobulin, α-lactalbumin, immunoglobulin and bovine serum albumin were 3.35%, 10.5%, 7.89%, 18.8%, 53.6%, 20.1%, 26.9 and 37.5%. After 90 days of storage, the decline in αs1-casein, αs2-casein, β-casein, κ-casein, β-lactoglobulin, α-lactalbumin, immunoglobulin and bovine serum albumin were 11.2%, 34.8%, 14.3%, 33.9%, 56.9%, 24.8%, 36.5% and 43.1%. Hydroxy methyl furfural content of UHT milk at 0, 45 and 90 days of storage were 1.56, 4.18 and 7.61 (µmol/L). Furosine content of flavored UHT milk at 0, 45 and 90 days of storage intervals were 278, 392 and 561 mg/100g protein. Nε-carboxymethyl-l-lysine content of UHT flavored milk at 0, 45 and 90 days of storage were 67, 135 and 343mg/kg protein. After 90 days of storage of flavored UHT milk, the loss of unsaturated fatty acids 45.7% from the initial values. At 0, 45 and 90 days of storage, free fatty acids of flavored UHT milk were 0.08%, 0.11% and 0.16% (p<0.05). Peroxide value of flavored UHT milk at 0, 45 and 90 days of storage was 0.22, 0.65 and 2.88 (MeqO²/kg). Sensory analysis of flavored UHT milk after 90 days indicated that appearance, flavor and mouth feel score significantly decreased from the initial values recorded at 0 day. Findings of this investigation evidenced that in flavored UHT milk more pronounced changes take place in protein profile, Maillard reaction products and lipid oxidation as compared to normal UHT milk.

Keywords: UHT flavored milk , hydroxymethyl furfural, lipid oxidation, sensory properties

Procedia PDF Downloads 199

Authors: Tobias Schramm, Günther Prokop

Abstract:

The average age of passenger cars is rising steadily around the world. Older vehicles are more sensitive to the degradation of chassis components. A higher age and a higher mileage of passenger cars correlate with an increased failure rate of vehicle shock absorbers. The most common degradation mechanism of vehicle shock absorbers is the loss of oil and gas. It is not yet fully understood how the loss of oil and gas in twin-tube shock absorbers affects the lateral dynamics of passenger cars. The aim of this work is to estimate the effect of degraded twin-tube shock absorbers of passenger cars on their safety-critical lateral dynamics. A characteristic curve-based five-mass full vehicle model and a semi-physical phenomenological shock absorber model were set up, parameterized and validated. The shock absorber model is able to reproduce the damping characteristics of vehicle twin-tube shock absorbers with oil and gas loss for various excitations. The full vehicle model was used to simulate stationary cornering and steering wheel angle step maneuvers on road classes A to D. The simulations were carried out in a realistic parameter space in order to demonstrate the influence of various vehicle characteristics on the effect of degraded shock absorbers. As a result, it was shown that degraded shock absorbers have a negative effect on the understeer gradient of vehicles. For stationary lateral dynamics, degraded shock absorbers for high road excitations reduce the maximum lateral accelerations. Degraded rear axle shock absorbers can change the understeer gradient of a vehicle in the direction of oversteer. Degraded shock absorbers also lead to increased rolling angles. Furthermore, degraded shock absorbers have a major impact on driving stability during steering wheel angle steps. Degraded rear axle shock absorbers, in particular, can lead to unstable handling. Especially the tire stiffness, the unsprung mass and the stabilizer stiffness influence the effect of degraded shock absorbers on the lateral dynamics of passenger cars.

Keywords: driving dynamics, numerical simulation, road safety, shock absorber degradation, stationary and nonstationary lateral dynamics.

Procedia PDF Downloads 8

Authors: Youtao Gao, Bingyu Jin, Tanran Zhao, Bo Xu

Abstract:

The history of satellite navigation can be dated back to the 1960s. From the U.S. Transit system and the Russian Tsikada system to the modern Global Positioning System (GPS) and the Globalnaya Navigatsionnaya Sputnikovaya Sistema (GLONASS), performance of satellite navigation has been greatly improved. Nowadays, the navigation accuracy and coverage of these existing systems have already fully fulfilled the requirement of near-Earth users, but these systems are still beyond the reach of deep space targets. Due to the renewed interest in space exploration, a novel high-precision satellite navigation system is becoming even more important. The increasing demand for such a deep space navigation system has contributed to the emergence of a variety of new constellation architectures, such as the Lunar Global Positioning System. Apart from a Walker constellation which is similar to the one adopted by GPS on Earth, a novel constellation architecture which consists of libration point satellites in the Earth-Moon system is also available to construct the lunar navigation system, which can be called accordingly, the libration point satellite navigation system. The concept of using Earth-Moon libration point satellites for lunar navigation was first proposed by Farquhar and then followed by many other researchers. Moreover, due to the special characteristics of Libration point orbits, an autonomous orbit determination technique, which is called ‘Liaison navigation’, can be adopted by the libration point satellites. Using only scalar satellite-to-satellite tracking data, both the orbits of the user and libration point satellites can be determined autonomously. In this way, the extensive Earth-based tracking measurement can be eliminated, and an autonomous satellite navigation system can be developed for future space exploration missions. The method of state estimate is an unnegligible factor which impacts on the orbit determination accuracy besides type of orbit, initial state accuracy and measurement accuracy. We apply the extended Kalman filter(EKF) and the unscented Kalman filter(UKF) to determinate the orbits of Lagrangian navigation satellites. The autonomous orbit determination errors are compared. The simulation results illustrate that UKF can improve the accuracy and z-axis convergence to some extent.

Keywords: extended Kalman filter, autonomous orbit determination, unscented Kalman filter, navigation constellation

Procedia PDF Downloads 285

Authors: Rajkumar Ghosh, Ananya Mukhopadhyay

Abstract:

This scientific paper presents a thorough investigation into the integration of roof-mounted photovoltaic (PV) array systems and home rooftop rainwater collection systems in a remote community in Himachal Pradesh, India, with the goal of optimum utilization of natural resources for attaining sustainable living conditions by 2030. The study looks into the technical feasibility, environmental benefits, and socioeconomic impacts of this integrated method, emphasizing its ability to handle energy and water concerns in remote rural regions. This comprehensive method not only provides a sustainable source of electricity but also ensures a steady supply of clean water, promoting resilience and improving the quality of life for the village's residents. This research highlights the potential of such integrated systems in supporting sustainable conditions in rural areas through a combination of technical feasibility studies, economic analysis, and community interaction. There would be 20690 villages and 1.48 million homes (23.79% annual growth rate) in Himachal Pradesh if all residential buildings in the state had roof-mounted photovoltaic arrays to capture solar energy for power generation. The energy produced is utilized to power homes, lessening dependency on traditional fossil fuels. The same residential buildings housed domestic rooftop rainwater collection systems. Rainwater runoff from rooftops is collected and stored in tanks for use in a number of residential purposes, such as drinking, cooking, and irrigation. The gathered rainfall enhances the region's limited groundwater resources, easing the strain on local wells and aquifers. Although Himachal Pradesh of India is a Power state, the PV arrays have reduced the reliance of village on grid power and diesel generators by providing a steady source of electricity. Rooftop rainwater gathering has not only increased residential water supply but it has also lessened the burden on local groundwater resources. This helps to replenish groundwater and offers a more sustainable water supply for the town. The neighbourhood has saved money by utilizing renewable energy and rainwater gathering. Furthermore, lower fossil fuel consumption reduces greenhouse gas emissions, which helps to mitigate the effects of climate change. The integrated strategy of installing grid connected rooftop photovoltaic arrays and home rooftop rainwater collecting systems in Himachal Pradesh rural community demonstrates a feasible model for sustainable development. According to “Swaran Jayanti Energy Policy of Himachal Pradesh”, Himachal Pradesh is planned 10 GW from rooftop mode from Solar Power. Government of India provides 40% subsidy on solar panel of 1-3 kw and subsidy of Rs 6,000 per kw per year to encourage domestic consumers of Himachal Pradesh. This effort solves energy and water concerns, improves economic well-being, and helps to conserve the environment. Such integrated systems can serve as a model for sustainable development in rural areas not only in Himachal Pradesh, but also in other parts of the world where resource scarcity is a major concern. Long-term performance and scalability of such integrated systems should be the focus of future study. Efforts should also be made to duplicate this approach in other rural areas and examine its socioeconomic and environmental implications over time.

Keywords: renewable energy, photovoltaic arrays, rainwater harvesting, sustainability, rural development, Himachal Pradesh, India

Procedia PDF Downloads 100

Authors: Ana Miguel

Abstract:

Purpose: Glaucoma is the second cause of worldwide blindness and the first cause of irreversible blindness. Trabeculectomy, the standard glaucoma surgery, has a success rate between 36.0% and 98.0% at three years and a high complication rate, leading to the development of different surgeries, micro-invasive glaucoma surgeries (MIGS). MIGS devices are diverse and have various indications, risks, and effectiveness. We intended to review MIGS’ surgical techniques, indications, contra-indications, and IOP effect. Methods: We performed a literature review of MIGS to differentiate the devices and their reported effectiveness compared to traditional surgery (tubes and blebs). We also conducted a video review of the last 1000 glaucoma surgeries of the author (including MIGS, but also trabeculectomy, deep sclerectomy, and tubes of Ahmed and Baerveldt) performed at glaucoma and advanced anterior segment fellowship in Canada and France, to describe preferred surgical techniques for each. Results: We present the videos with surgical techniques and pearls for each surgery. Glaucoma surgeries included: 1- bleb surgery (namely trabeculectomy, with releasable sutures or with slip knots, deep sclerectomy, Ahmed valve, Baerveldt tube), 2- MIGS with bleb, also known as MIBS (including XEN 45, XEN 63, and Preserflo), 3- MIGS increasing supra-choroidal flow (iStar), 4-MIGS increasing trabecular flow (iStent, gonioscopy-assisted transluminal trabeculotomy - GATT, goniotomy, excimer laser trabeculostomy -ELT), and 5-MIGS decreasing aqueous humor production (endocyclophotocoagulation, ECP). There was also needling (ab interno and ab externo) performed at the operating room and irido-zonulo-hyaloïdectomy (IZHV). Each technique had different indications and contra-indications. Conclusion: MIGS are valuable in glaucoma surgery, such as traditional surgery with trabeculectomy and tubes. All glaucoma surgery can be combined with phacoemulsification (there may be a synergistic effect on MIGS + cataract surgery). In addition, some MIGS may be combined for further intraocular pressure lowering effect (for example, iStents with goniotomy and ECP). A good surgical technique and postoperative management are fundamental to increasing success and good practice in all glaucoma surgery.

Keywords: glaucoma, migs, surgery, video, review

Procedia PDF Downloads 83

Authors: Archana Gupta, Rajesh Kumar

Abstract:

The chemistry of chalcones has generated intensive scientific studies throughout the world. Especially, interest has been focused on the synthesis and biodynamic activities of chalcones. The blue light transmittance, excellent crystallizability and the two planar rings connected through a conjugated double bond show that chalcone derivatives are superior nonlinear organic compounds. 3-(2-Chloro-6-fluoro¬phen¬yl)-1-(2-thien¬yl) prop-2-en-1-one, 3-(2, 4- Dichlorophenyl) – 1 - (4-methylphenyl) – prop -2-en-1-one, (2E)-3-[4-(methylsulfanyl) phenyl]-1-(4-nitrophenyl) prop-2-en-1-one are some chalcone derivatives exhibiting non linear optical (NLO) properties. NLO materials have been extensively investigated in recent years as they are the key elements for photonic technologies of optical communication, optical interconnect oscillator, amplifier, frequency converter etc. Due to their high molecular hyperpolarizabilities, organic materials display a number of significant NLO properties. Experimental measurements and theoretical calculations on molecular hyperpolarizability β have become one of the key factors in the design of second order NLO materials. Theoretical determination of hyperpolarizability is quite useful both in understanding the relationship between the molecular structure and NLO properties. It also provides a guideline to experimentalists for the design and synthesis of organic NLO materials. Quantum-chemical calculations have made an important contribution to the understanding of the electronic polarization underlying the molecular NLO processes and the establishment of structure–property relationships. In the present investigation, the detailed vibrational analysis of some chalcone derivatives is taken up to understand the correlation of the charge transfer interaction and the NLO activity of the molecules based on density functional theory calculations. The vibrational modes contributing toward the NLO activity have been identified and analyzed. Rather large hyperpolarizability derived by theoretical calculations suggests the possible future use of these compounds for non-linear optical applications. The study suggests the importance of π - conjugated systems for non-linear optical properties and the possibility of charge transfer interactions. We hope that the results of the present study of chalcone derivatives are of assistance in development of new efficient materials for technological applications.

Keywords: hyperpolarizability, molecular structure, NLO material, quantum chemical calculations

Procedia PDF Downloads 234

Authors: Kyra Kannen, Sonja D. Roelen, Sebastian Schnieder, Jarek Krajewski, Steffen Holsteg, André Karger, Johanna Askeridis, Celina Slawik, Philip Mildner, Jens Piesk, Ruslan David, Holger Kürten, Benjamin Oster, Robert Malzan, Mike Ludemann

Abstract:

Virtual Reality (VR) is increasingly recognized for its potential in transforming mental disorder treatment, offering advantages such as cost-effectiveness, time efficiency, accessibility, reduced stigma, and scalability. While the application of VR in the context of anxiety disorders has been extensively evaluated and demonstrated to be effective, the utilization of VR as a therapeutic treatment for depression remains under-investigated. Our goal is to pioneer immersive VR therapy modules for treating major depression, alongside a web-based system for home use. We develop a modular digital therapy platform grounded in psychodynamic therapy interventions which addresses stress reduction, exploration of social situations and relationship support, social skill training, avoidance behavior analysis, and psychoeducation. In addition, an automated depression monitoring system, based on acoustic voice analysis, is implemented in the form of a speech-based diary to track the affective state of the user and depression severity. The use of immersive VR facilitates patient immersion into complex and realistic interpersonal interactions with high emotional engagement, which may contribute to positive treatment acceptance and satisfaction. In a proof-of-concept study, 45 depressed patients were assigned to VR or web-platform modules, evaluating user experience, usability and additional metrics including depression severity, mindfulness, interpersonal problems, and treatment satisfaction. The findings provide valuable insights into the effectiveness and user-friendliness of VR and web modules for depression therapy and contribute to the refinement of more tailored digital interventions to improve mental health.

Keywords: virtual reality therapy, digital health, depression, psychotherapy

Procedia PDF Downloads 63

Authors: Rita Phillips, Mark Burgess, Maga Berlinski

Abstract:

Although the positive impact of religiosity on well-being, health, and life-coping abilities is well known, up to date research has failed to provide scientific evidence for the relationship reasons. Therefore the present study took a qualitative approach by examining how religiosity interacts in coping with emotionally distressful situations, for which wedding preparations are an example. Wedding preparations, related to the experience of ambiguous emotions, can be the reason for phases of high distress. Although being per-se religious ceremonies, they are also socially-scripted and characterized by people’s striving for personally meaningful celebrations. The negotiation of these many influences can evoke conflicts. To reveal components of religiosity which contribute to stress-resolution, eight biographic-narrative interviews with recently married spouses were conducted. Participants were from different nationalities and Catholic deep-belief communities in order to determine factors independent from national-culture and social-subgroup. The audio-tape recorded, transcribed and translated interviews were analyzed by Interpretative Phenomenological Analysis. Opposing previous research on wedding-related conflicts but in-line with the quantitative account on the relation between stress-resilience and religiosity, the present study found participants reporting very low levels of distress and ambiguity. Although similar areas of potential conflicts were revealed, deep-belief Christians seemed to handle them in a different way. Participants freed themselves from own and others’ rigor mundane expectations by their spiritual preparation and the focus on a divine instance. This evoked a feeling of perceived closeness to God and of unconditional love, resulting in acceptance of oneself and others. Through relativizing mundane goods, participants perceived absolute freedom. Thus belief did not supplement coping strategies, previously defined in the literature, but substituted them. The paper implies that in explaining the connection between stress-resilience and religiosity, one’s perception and experience of unconditional love might outweigh other social or personal factors. However, further qualitative investigations are needed to fully explain the phenomenon.

Keywords: deep-belief, religiosity, resilience, wedding

Procedia PDF Downloads 244

Authors: Se-Hwa Park, En-Kyung Han, Jae-Young Lim, Hye-Jung Ahn

Abstract:

Purpose: The objective of this study is to provide basic data for understanding the substance of inpatient life with CRPS (Complex Regional Pain Syndrome) and developing efficient and effective nursing intervention. Methods: From September 2018 to November, we have interviewed 10 CRPS patients about inpatient experiences. To understand the implication of inpatient life experiences with CRPS and intrinsic structure, we have used the question: 'How about the inpatient experiences with CRPS'. For data analysis, the method suggested by Colaizzi was applied as a phenomenological method. Results: According to the analysis, the study participants' inpatient life process was structured in six categories: (a) breakthrough pain experience (b) the limitation of pain treatment, (c) worsen factors of pain during inpatient period, (d) treat method for pain, (e) positive experience for inpatient period, (f) requirements for medical team, family and people in hospital room. Conclusion: Inpatient with CRPS have experienced the breakthrough pain. They had expected immediate treatment for breakthrough pain, but they experienced severe pain because immediate treatment was not implemented. Pain-worsening factors which patients with CRPS are as follows: personal factors from negative emotions such as insomnia, stress, sensitive character, pain part touch or vibration stimulus on the bed, physical factors from high threshold or rapid speed during fast transfer, conflict with other people, climate factors such as humidity or low temperature, noise, smell, lack of space because of many visitors. Patients actively manage the pain committing into another tasks or diversion. And also, patients passively manage the pain, just suppress, give-up. They think positively about rehabilitation treatment. And they require the understanding and sympathy for other people, and emotional support, immediate intervention for medical team. Based on the results of this study, we suppose the guideline of systematic breakthrough pain management for the relaxation of sudden pain, using notice of informing caution for touch or vibration. And we need to develop non-medicine pain management nursing intervention.

Keywords: breakthrough pain, CRPS, complex regional pain syndrome, inpatient life experiences, phenomenological method

Procedia PDF Downloads 129

Authors: Robert E. Kenney, Efrain Antunez, Samuel Nodal, Ameer Malik, Richard B. Aguilar

Abstract:

Physician burnout has gained much attention during the COVID pandemic. After-hours workload, HCC coding, HEDIS metrics, and clinical documentation negatively impact career satisfaction. These and other influences have increased the rate of physicians leaving the workforce. In addition, roughly 1% of the entire physician workforce will be retiring earlier than expected based on pre-pandemic trends. The two Medical Specialties with the highest rates of burnout are Family Medicine and Primary Care. With a predicted shortage of primary care physicians looming, the need to address physician burnout is crucial. Commonly reported issues leading to clinician burnout are clerical documentation requirements, increased time working on Electronic Health Records (EHR) after hours, and a decrease in work-life balance. Clinicians experiencing burnout with physical and emotional exhaustion are at an increased likelihood of providing lower quality and less efficient patient care. This may include a lack of suitable clinical documentation, medication reconciliation, clinical assessment, and treatment plans. While the annual baseline turnover rates of physicians hover around 6-7%, the COVID pandemic profoundly disrupted the delivery of healthcare. A report found that 43% of physicians switched jobs during the initial two years of the COVID pandemic (2020 and 2021), tripling the expected average annual rate to 21.5 %/yr. During this same time, an average of 4% and 1.5% of physicians retired or left the workforce for a non-clinical career, respectively. The report notes that 35.2% made career changes for a better work-life balance and another 35% reported the reason as being unhappy with their administration’s response to the pandemic. A physician-led primary care-focused health organization, Cano Health (CH), based out of Florida, sought to preemptively address this problem by implementing several supportive measures. Working with >120 clinics and >280 PCPs from Miami to Tampa and Orlando, managing nearly 120,000 Medicare Advantage lives, CH implemented a number of changes to assist with the clinician’s workload. Supportive services such as after hour and home visits by APRNs, in-clinic care managers, and patient educators were implemented. In 2021, assistive Artificial Intelligence Software (AIS) was integrated into the EHR platform. This AIS converts free text within PDF files into a usable (copy-paste) format facilitating documentation. The software also systematically and chronologically organizes clinical data, including labs, medical records, consultations, diagnostic images, medications, etc., into an easy-to-use organ system or chronic disease state format. This reduced the excess time and documentation burden required to meet payor and CMS guidelines. A clinician Documentation Support team was employed to improve the billing/coding performance. The effects of these newly designed workflow interventions were measured via analysis of clinician turnover from CH’s hiring and termination reporting software. CH’s annualized average clinician turnover rate in 2020 and 2021 were 17.7% and 12.6%, respectively. This represents a 30% relative reduction in turnover rate compared to the reported national average of 21.5%. Retirement rates during both years were 0.1%, demonstrating a relative reduction of >95% compared to the national average (4%). This model successfully promoted the retention of clinicians in a Value-Based Care setting.

Keywords: clinician burnout, COVID-19, value-based care, burnout, clinician retirement

Procedia PDF Downloads 82

Authors: Khaled Al-Badani, Andrew Norbury, Essam Elmshawet, Glynn Rotwell, Ian Jenkinson , James Ren

Abstract:

Micro welding procedures are widely used for joining materials, developing duplex components or functional surfaces, through various methods such as Micro Discharge Welding or Spot Welding process, which can be found in the engineering, aerospace, automotive, biochemical, biomedical and numerous other industries. The relationship between the material properties, structure and processing is very important to improve the structural integrity and the final performance of the welded joints. This includes controlling the shape and the size of the welding nugget, state of the heat affected zone, residual stress, etc. Nowadays, modern high volume productions require the welding of much versatile shapes/sizes and material systems that are suitable for various applications. Hence, an improved understanding of the micro welding process and the digital tools, which are based on computational numerical modelling linking key welding parameters, dimensional attributes and functional performance of the weldment, would directly benefit the industry in developing products that meet current and future market demands. This paper will introduce recent work on developing an integrated experimental and numerical modelling code for micro welding techniques. This includes similar and dissimilar materials for both ferrous and non-ferrous metals, at different scales. The paper will also produce a comparative study, concerning the differences between the micro discharge welding process and the spot welding technique, in regards to the size effect of the welding zone and the changes in the material structure. Numerical modelling method for the micro welding processes and its effects on the material properties, during melting and cooling progression at different scales, will also be presented. Finally, the applications of the integrated numerical modelling and the material development for the digital manufacturing of welding, is discussed with references to typical application cases such as sensors (thermocouples), energy (heat exchanger) and automotive structures (duplex steel structures).

Keywords: computer modelling, droplet formation, material distortion, materials forming, welding

Procedia PDF Downloads 255

Authors: I Putu Indra Kusuma

Abstract:

The rapid development of Information and Communication Technology (ICT) tools has improved the implementation of flipped classrooms in English Language Teaching (ELT), especially in speaking course. Flipped classrooms have therefore evolved from the oldest version, which uses recorded videos to the newest one (3.0 version), which combines various materials and enables out-of-class interaction and learning engagement. However, how the latest version of flipped classrooms affects students’ speaking performance and influences students’ learning engagement remains unclear. This study therefore sought (1) to examine the effect of flipped classrooms 3.0 towards students’ speaking performance and (2) to explore the students’ learning engagement during the implementation of flipped classrooms in the speaking course. This study then employed explanatory sequential mixed-method design. This study conducted a quasi-experimental study by recruiting 164 twelfth grade students of a public senior high school in Indonesia as the sample. They were distributed into experimental (80 students) and control (84 students) groups. The experimental group was treated by implementing flipped classrooms with various use of ICT tools such as Schoology, Youtube, websites, and Flipgrid for eight weeks. Meanwhile, the control group implemented a conventional method. Furthermore, there were two variables examined in this study, such as the implementation of flipped classrooms 3.0 as the independent variable and students’ speaking performance as the dependent variable. The data of these two variables were then collected through administering a speaking test to both groups. The data from this experimental study were analyzed by using independent t-test analysis. Also, five students were invited to participate in semi-structured interviews to explore their learning engagement during the implementation of flipped classrooms. The findings revealed that there was a significant difference in students’ speaking performance between experimental where t (df = 162) = 5.810, p < 0.001, d = 0.91 in which experimental group performed better in speaking than the control group. Also, the results of interviews showed that the students had positive learning engagement during the implementation of flipped classrooms 3.0, especially on out-of-class interactions and face-to-face meetings. Some relevant implications to ELT, especially in speaking courses, are also drawn from the data findings. From the findings, it can be concluded that flipped classrooms 3.0 has a significant effect on students’ speaking performance and it promotes students’ learning engagement. Therefore, flipped classrooms 3.0 should be embraced as the newest version of flipped classrooms that promotes interaction outside the classrooms and learning engagement.

Keywords: Flipped Classrooms 3.0, learning engagement, teaching speaking with technology, technology-enhanced language learning

Procedia PDF Downloads 132

Authors: Mylene T. Caytap-Milan

Abstract:

This study was materialized with the purpose of determining the anxieties of students towards spoken English, sources of the specified anxiety, coping mechanisms to counter the apprehensions, and teacher management to reduce the anxiety within the classroom. Being qualitative in nature, interview as the data gathering tool was utilized with an audio-recorder. Participants of the study included thirteen teachers and students of speech classes in a state university in Region I, Philippines. Data elicited were transcribed in verbatim, confirmed by the participants, coded and categorized, and themed accordingly. A triangulation method was applied to establish the stronger validity of the data. Findings confirmed teachers’ and students’ awareness of the existence of Anxiety in speaking English (ASE). Based on the data gathered from the teachers, the following themes on students’ ASE were identified: (1) No Brain and Mouth Coordination, (2) Center of Attention, and (3) Acting Out Loud. However, the following themes were formulated based on the responses made by the students themselves: (1) The Common Feeling, (2) The Incompetent Me, and (3) The Limelight. With regard the sources of students’ ASE according to teachers are the following: (1) It Began at Home, (2) It Continued in School, (3) It’s not for me at all. On the other hand, the sources of students’ ASE according to students themselves are: (1) It Comes from Within, (2) It wasn’t Nursed Well, and (3) They’re Looking for Errors. In terms of coping with ASE, students identified the following mechanisms, which were themed into: (1) Acceptance, (2) Application, and (3) Apathy. Moreover, to reduce the ASE phenomenon within the classroom, the teachers demonstrate the following roles according to themes: (1) The Compass, (2) The Counselor, (3) The Referee, (4) The Polyglot, and (5) The English Nazi. Based on the findings, the following conclusions were drawn: (1) ASE can both serve positive and negative influences to the English speaking skills of students, (2) ASE can be reduced with teachers’ provision of more English speaking opportunities and with students’ initiative of personal training, (3) ASE can be reduced when English is introduced and practiced by children at an early age, and (4) ASE is inevitable in the affective domain thus teachers are encouraged to apply psychological positivism in the classroom. Studies related to the present undertaking may refer to the succeeding recommendations: (1) experiment on activities that will reduce anxiety ASE, (2) involve a psychologist for more critical but reliable results and recommendations, and (3) conduct the study among high school and primary students.

Keywords: coping mechanisms, sources, speaking anxiety, teacher management

Procedia PDF Downloads 115

Authors: Ouabo Emmanuel Romaric, Amougou Armathe

Abstract:

Background and aim: The study of impacts of floods and landslides at a small scale, specifically in the urban areas of developing countries is done to provide tools and actors for a better management of risks in such areas, which are now being affected by climate change. The main objective of this study is to assess the hydrometeorological vulnerabilities associated with flooding and urban landslides to propose adaptation measures. Methods: Climatic data analyses were done by calculation of indices of climate change within 50 years (1960-2012). Analyses of field data to determine causes, the level of risk and its consequences on the area of study was carried out using SPSS 18 software. The cartographic analysis and GIS were used to refine the work in space. Then, spatial and terrain analyses were carried out to determine the morphology of field in relation with floods and landslide, and the diffusion on the field. Results: The interannual changes in precipitation has highlighted the surplus years (21), the deficit years (24) and normal years (7). Barakat method bring out evolution of precipitation by jerks and jumps. Floods and landslides are correlated to high precipitation during surplus and normal years. Data field analyses show that populations are conscious (78%) of the risks with 74% of them exposed, but their capacities of adaptation is very low (51%). Floods are the main risk. The soils are classed as feralitic (80%), hydromorphic (15%) and raw mineral (5%). Slope variation (5% to 15%) of small hills and deep valley with anarchic construction favor flood and landslide during heavy precipitation. Mismanagement of waste produce blocks free circulation of river and accentuate floods. Conclusion: Vulnerability of population to hydrometeorological risks in Yaoundé VI is the combination of variation of parameters like precipitation, temperature due to climate change, and the bad planning of construction in urban areas. Because of lack of channels for water to circulate due to saturation of soils, the increase of heavy precipitation and mismanagement of waste, the result are floods and landslides which causes many damages on goods and people.

Keywords: climate change, floods, hydrometeorological, vulnerability

Procedia PDF Downloads 466

Authors: Bin Zhou, Tongli Lu, Jianwu Zhang, Hongtao Hao

Abstract:

Dual clutch transmissions (DCT) offer a high comfort performance in terms of the gearshift. Hydraulic multi-disk clutches are the key components of DCT, its engagement determines the shifting comfort. The prefill of the clutches requests an initial engagement which the clutches just contact against each other but not transmit substantial torque from the engine, this initial clutch engagement point is called the touch point. Open-loop control is typically implemented for the clutch prefill, a lot of uncertainties, such as oil temperature and clutch wear, significantly affects the prefill, probably resulting in an inappropriate touch point. Underfill causes the engine flaring in gearshift while overfill arises clutch tying up, both deteriorating the shifting comfort of DCT. Therefore, it is important to enable an adaptive capacity for the clutch prefills regarding the uncertainties. In this paper, a dynamic model of the hydraulic actuator system is presented, including the variable force solenoid and clutch piston, and validated by a test. Subsequently, the open-loop clutch prefill is simulated based on the proposed model. Two control parameters of the prefill, fast fill time and stable fill pressure is analyzed with regard to the impact on the prefill. The former has great effects on the pressure transients, the latter directly influences the touch point. Finally, an adaptive method is proposed for the clutch prefill during gear shifting, in which clutch fill control parameters are adjusted adaptively and continually. The adaptive strategy is changing the stable fill pressure according to the current clutch slip during a gearshift, improving the next prefill process. The stable fill pressure is increased by means of the clutch slip while underfill and decreased with a constant value for overfill. The entire strategy is designed in the Simulink/Stateflow, and implemented in the transmission control unit with optimization. Road vehicle test results have shown the strategy realized its adaptive capability and proven it improves the shifting comfort.

Keywords: clutch prefill, clutch slip, dual clutch transmission, touch point, variable force solenoid

Procedia PDF Downloads 308